Abstract

Study objective: Although moderate alcohol intake is related to decreased all cause and ischaemic heart disease mortality, intake of large
amounts at a time may be harmful.

Design: A cohort study, average follow up time was 7.3 years.

Setting: Finland.

Participants: General population sample of 5092 men, aged from 25 to 64 years, who had consumed alcohol during the 12 months before the
baseline examination.

Main results: The main outcome measure was death. After excluding cases with previous myocardial infarction at the baseline examination
and after adjustment for age, education, smoking, and average alcohol intake in Cox proportional hazards model, subjects with
heavy drinking pattern (six or more drinks at a time) still had higher mortality from all causes than drinkers without heavy
drinking occasions (RR 1.57; 95% CI 1.17 to 2.10). Respective analyses showed increased risk also for ischaemic heart disease
(1.77; 95% CI 1.01 to 3.08), external causes (2.90; 95% CI 1.47 to 5.72) and alcohol related causes of death (2.73; 95% CI
1.13 to 6.64). The last two risk ratios were not adjusted for smoking. Relative risk point estimates were approximately similar
for drinkers with heavy drinking occasions irrespective of beverage type, although those for beer and wine did not reach significance,
probably because of the small number of cases. The highest average alcohol intake was found among drinkers who consumed all
three types of beverage.

Conclusions: Consuming six or more drinks at a time is related to increased mortality among working age male drinkers. The authors found
no clear evidence for beverage specific differences.